The Role of Renal Pelvis Urine Attenuation Value in Forecasting Infection Risk After Mini-Percutaneous Nephrolithotomy.

IF 1.1 4区 医学 Q3 SURGERY
Huseyin Burak Yazili, Ufuk Caglar, Ahmet Halis, Oguzhan Yildiz, Arda Meric, Resit Yusuf, Omer Sarilar, Faruk Ozgor
{"title":"The Role of Renal Pelvis Urine Attenuation Value in Forecasting Infection Risk After Mini-Percutaneous Nephrolithotomy.","authors":"Huseyin Burak Yazili, Ufuk Caglar, Ahmet Halis, Oguzhan Yildiz, Arda Meric, Resit Yusuf, Omer Sarilar, Faruk Ozgor","doi":"10.1177/10926429251381201","DOIUrl":null,"url":null,"abstract":"<p><p><b><i>Objective:</i></b> To evaluate whether renal pelvis urine density (RPUD), measured on preoperative computed tomography (CT), predicts infectious complications following percutaneous nephrolithotomy (PCNL). <b><i>Methods:</i></b> This retrospective study included patients who underwent PCNL between June 2019 and June 2024 at a tertiary care center. Patients with preoperative infection signs, drainage devices, or incomplete data were excluded. All included patients had sterile urine cultures preoperatively. RPUD was measured on noncontrast CT by two independent urologists, and interobserver agreement was calculated. Patients were grouped according to the presence of postoperative infectious complications (fever, sepsis, or septic shock). Demographic and perioperative variables were compared. Logistic regression was used to identify independent predictors of infection. <b><i>Results:</i></b> A total of 226 patients were analyzed. Patients with postoperative infections had significantly higher RPUD values (13.7 versus 6.0 Hounsfield units, <i>P</i> = .001) and longer operative times (70 versus 50 minutes, <i>P</i> = .001). On multivariate analysis, both RPUD (odds ratio: 1.238) and operative time (odds ratio: 1.055) were independent predictors. ROC analysis showed that an RPUD cutoff of 9.250 predicted infection with 80.0% sensitivity and 80.1% specificity (AUC: 0.875). Interobserver reliability for RPUD was excellent (intraclass correlation coefficient: 0.942). <b><i>Conclusions:</i></b> Preoperative RPUD is a reliable, noninvasive radiological marker for predicting infectious complications after PCNL. Routine measurement of RPUD may improve preoperative risk stratification and optimize perioperative management. These findings should be validated in future prospective, multicenter studies.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1000,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Laparoendoscopic & Advanced Surgical Techniques","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/10926429251381201","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0

Abstract

Objective: To evaluate whether renal pelvis urine density (RPUD), measured on preoperative computed tomography (CT), predicts infectious complications following percutaneous nephrolithotomy (PCNL). Methods: This retrospective study included patients who underwent PCNL between June 2019 and June 2024 at a tertiary care center. Patients with preoperative infection signs, drainage devices, or incomplete data were excluded. All included patients had sterile urine cultures preoperatively. RPUD was measured on noncontrast CT by two independent urologists, and interobserver agreement was calculated. Patients were grouped according to the presence of postoperative infectious complications (fever, sepsis, or septic shock). Demographic and perioperative variables were compared. Logistic regression was used to identify independent predictors of infection. Results: A total of 226 patients were analyzed. Patients with postoperative infections had significantly higher RPUD values (13.7 versus 6.0 Hounsfield units, P = .001) and longer operative times (70 versus 50 minutes, P = .001). On multivariate analysis, both RPUD (odds ratio: 1.238) and operative time (odds ratio: 1.055) were independent predictors. ROC analysis showed that an RPUD cutoff of 9.250 predicted infection with 80.0% sensitivity and 80.1% specificity (AUC: 0.875). Interobserver reliability for RPUD was excellent (intraclass correlation coefficient: 0.942). Conclusions: Preoperative RPUD is a reliable, noninvasive radiological marker for predicting infectious complications after PCNL. Routine measurement of RPUD may improve preoperative risk stratification and optimize perioperative management. These findings should be validated in future prospective, multicenter studies.

肾盂尿衰减值在预测小经皮肾镜取石术后感染风险中的作用。
目的:评价术前计算机断层扫描(CT)测量肾盂尿密度(RPUD)对经皮肾镜取石术(PCNL)后感染并发症的预测价值。方法:本回顾性研究包括2019年6月至2024年6月在三级保健中心接受PCNL的患者。排除术前有感染迹象、引流装置或数据不完整的患者。所有患者术前均行无菌尿培养。RPUD由两名独立的泌尿科医生在非对比CT上测量,并计算观察者间的一致性。患者根据术后感染并发症(发热、败血症或感染性休克)的存在进行分组。比较人口学和围手术期变量。使用逻辑回归来确定感染的独立预测因子。结果:共分析226例患者。术后感染患者的RPUD值明显更高(13.7比6.0 Hounsfield单位,P = .001),手术时间更长(70比50分钟,P = .001)。在多因素分析中,RPUD(优势比:1.238)和手术时间(优势比:1.055)是独立的预测因素。ROC分析显示,RPUD截止值为9.250,预测感染的敏感性为80.0%,特异性为80.1% (AUC: 0.875)。RPUD的观察者间信度极好(类内相关系数:0.942)。结论:术前RPUD是预测PCNL术后感染并发症的可靠、无创的放射学指标。常规测量RPUD可改善术前风险分层,优化围手术期管理。这些发现应该在未来的前瞻性多中心研究中得到验证。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
2.90
自引率
0.00%
发文量
163
审稿时长
3 months
期刊介绍: Journal of Laparoendoscopic & Advanced Surgical Techniques (JLAST) is the leading international peer-reviewed journal for practicing surgeons who want to keep up with the latest thinking and advanced surgical technologies in laparoscopy, endoscopy, NOTES, and robotics. The Journal is ideally suited to surgeons who are early adopters of new technology and techniques. Recognizing that many new technologies and techniques have significant overlap with several surgical specialties, JLAST is the first journal to focus on these topics both in general and pediatric surgery, and includes other surgical subspecialties such as: urology, gynecologic surgery, thoracic surgery, and more.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信